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Intravenous methadone for perioperative acute and chronic pain management in Chinese adult cardiac surgical patients: A protocol for pilot randomized controlled trial

Background Postoperative pain is significant in cardiac surgical patients. Perioperative analgesia with intermittent administration of opioids can result in significant fluctuations in serum opioid concentrations. Methadone should provide a rapid onset and long-term pain relief upon a single intravenous dose at induction of anesthesia, and may reduce chronic postsurgical pain (CPSP) in cardiac surgical patients. The feasibility of using intravenous methadone in Chinese cardiac surgical patients, and its effect on acute and chronic pain management after cardiac surgery will be evaluated. Methods A single-center, prospective, randomized-controlled pilot trial. Adult cardiac surgical patients will be randomized to receive 0.2 mg/kg methadone or morphine at induction of anesthesia. Patient-controlled analgesia morphine protocol, oral paracetamol and dihydrocodeine will be given for postoperative analgesia. Venous blood sampling for plasma methadone concentration will be obtained at regular intervals from study drug infusion to 96 hours after administration. The primary outcome will be a description of study feasibility, encompassing recruitment and retention, protocol adherence and stakeholder acceptability. Secondary outcomes include the time of ventilator weaning to spontaneous breathing, time of extubation, morphine requirements within 24 hours and 72 hours after surgery, time to first morphine rescue, postoperative pain scores, patient satisfaction, and length of stay in ICU and hospital. Opioid-related side effects including sedation, nausea and vomiting, and time to first bowel opening will be recorded. CPSP will be assessed with Neuropathic Pain Scale and Pain Catastrophizing Scale at 3 and 6 months after surgery. Discussion Randomized controlled trials on intravenous methadone in cardiac surgical patients are scarce, with none in Chinese populations. This study, supported by plasma methadone concentration analysis, will establish a basis for future large-scale research aimed at improving recovery through optimized pain management. Clinical trial registration ClinicalTrials.gov NCT05913284.

Diagnosis and classification of neuromuscular disorders using Bi-LSTM optimized with grey Wolf optimizer for EMG signals

The prospective acceptability of preventative IV bisphosphonate therapy prior to fracture: Perspectives of young people with Duchenne muscular dystrophy, parents and health professionals

Young people with Duchenne muscular dystrophy (DMD) commonly experience osteoporosis and fractures which can lead to chronic pain and reduced quality of life. Initiating IV bisphosphonate therapy prior to first fracture may be a logical primary preventative approach given the extent and related morbidity of osteoporosis, although there is limited evidence for this. This qualitative study using semi-structured interviews and focus groups, aimed to explore the opinions and prospective acceptability of young people with DMD, parents and health professionals in the UK on initiating bisphosphonate therapy prior to first fracture. Four boys with DMD (aged 15–17 years) and 20 parents participated in semi-structured interviews. Twenty-seven health professionals involved in the care of young people with DMD participated in focus groups. A framework analysis was conducted. Three categories were identified which represented a continuum of opinions on the endorsement of preventative bisphosphonate therapy: 1) “It buys them time”, endorsement of preventative bisphosphonate therapy; 2) Uncertainty and the importance of “choice”; and 3) “Worry about... starting bisphosphonates even earlier”, not endorsing the use of preventative bisphosphonate therapy. Young people with DMD and parents discussed a range of opinions about the prospective acceptability of IV bisphosphonate as preventative therapy, highlighting the importance of family choice before initiation of therapy. Health professionals called for future research exploring the risks and benefits of preventative IV bisphosphonate therapy for young people with DMD to inform clinical practice.

Milk NIR spectroscopy and Aquaphotomics novel diagnostic approach to Paratuberculosis in dairy cattle

Abstract Mycobacterium Avium subspecies Paratuberculosis (MAP) causes Johne’s disease or Paratuberculosis, a chronic, progressive intestinal disease in ruminants. The incidence and prevalence of Johne’s disease are higher in dairy cattle herds because of intensive breeding and high production. Developing non-destructive diagnostic methods for early detection of this disease by simple sampling is paramount for breeding, economic, and health programs. Conventional methods are almost entirely destructive, have low accuracy, and are time-consuming. Near- infrared spectroscopy (NIRS) and Aquaphotomics can detect changes in biofluids and thus have the potential to diagnose the disease. This study aimed to investigate the diagnostic ability of NIRS and Aquaphotomics for Paratuberculosis in dairy cattle by milk sample. Milk samples from dairy cattle were collected in the NIR range (1300–1600 nm) 60 days before and 100–200 days after calving in two groups, positive and negative, using the three same consecutive ELISA test results of blood plasma and milk, as a reference test. The NIRS and Aquaphotomics methods in quadratic discriminant analysis (QDA) and support vector machine (SVM) models achieved high accuracy in detecting negative and positive groups. In internal validation, SVM and QDA models in 12 water absorbance bands had 100% accuracy. In external validation, milk samples with blood plasma ELISA reference test achieved 100% sensitivity, which is more accurate than milk ELISA as a reference test. The current study found that monitoring milk with NIR spectra provides an opportunity to analyze antibody levels indirectly via changes in water spectral patterns caused by complex physiological changes, such as the amount of antibodies related to Paratuberculosis by aquagram.

Electronic Structure Tuning in Cu–Co Dual Single Atom Catalysts for Enhanced COOH* Spillover and Electrocalytic CO₂ Reduction Activity

AbstractThe development of efficient electrocatalysts for CO2 reduction to CO is challenging due to competing hydrogen evolution and intermediate over‐stabilization. In this study, a Cu–Co dual single‐atom catalyst (CuCo‐DSAC) anchored on carbon black was synthesized via scalable pyrolysis. The catalyst achieves 98.5% CO Faradaic efficiency at 500 mA cm−2, maintaining > 95% selectivity across a 400 mV window with < 6% decay over 48 h, which is superior to the corresponding single‐atom control samples. In situ spectroscopy and DFT calculations reveal a synergistic mechanism: Co sites activate CO2 and stabilize *COOH intermediates, while adjacent Cu sites facilitate CO desorption by lowering the energy barrier through charge redistribution. This dynamic buffer system mitigates active‐site blocking and suppresses HER by weakening H adsorption. The electronic interplay between Cu and Co optimizes intermediate energetics, enabling industrial‐level performance. This work demonstrates the potential of tailored dual‐site architectures for complex electrocatalytic processes, offering a promising approach to overcoming traditional limitations.

Synergy Between Weak Solvent and Solid Electrolyte Interphase Enables High‐Rate and Temperature‐Resilient Potassium Ion Batteries

AbstractThe rate and wide‐temperature performance of graphite‐based potassium‐ion batteries (PIBs) are limited by slow reaction kinetics at the interphases and the solid electrolyte interphase (SEI) stability. Herein, we strategically designed weak solvating electrolytes (WSEs) to construct an efficient solvated K+ desolvation with K2SO3‐rich SEI and achieve fast reaction kinetics at the electrode interface through the synergy between the SEI and the WSE. As a result of the beneficial fast reaction kinetics and stability of the electrode interface, the graphite anode shows high levels of rate performance and cycling stability, with a capacity of 249.6 mAh g−1 at 500 mA g−1 and 96.6% capacity retention after 1600 cycles. Moreover, assembled potassiated graphite (KC8)||Prussian blue nanoparticles (K‐PBNPs) cells in our designed electrolyte show high‐rate performance (63.1 mAh g−1 at 1500 mA g−1) and over wide operating temperature range (>99% Coulombic efficiency for over 1000 cycles and 200 cycles at −20°C and 80°C, respectively). Impressively, the pouch cell shows long‐term stability for 2400 cycles at 500 mAg−1. This work bridges a longstanding gap, elucidating the synergy between the SEI components and WSEs, leading to fast‐charging and temperature‐resilient PIBs.

Guiding ethical principles in transplant candidate selection committees: A scoping review protocol

Objective The goal of this scoping review is to examine the published literature regarding ethical principles that guide solid-organ transplant candidate selection committees. The review will identify the available research and provide recommendations to selection committees. Introduction Transplantation is a field where ethics is involved with almost every juncture of treatment. Organ selection, pathways to donation, organ allocation, and recipient selection are just a few of the myriads of processes that require ethical thoughtfulness. However, the ethical insights involved in the decision-making during these processes are not well elucidated in the literature. An application of an ethical framework(s) to this process could substantially improve the equality of the process. Inclusion criteria This review will include studies focused on transplant candidate selection committees and/or the transplant candidate selection process. It will include full papers and abstracts published in English. Methods PubMED, EMBASE, APA PsycInfo, SCOPUS, and CINAHL databases will be used for the literature search. Only articles published in English between the years 1960 and 2024 will be considered. The review will consist of title/abstract screening followed by full-text screening to determine which articles meet inclusion criteria. Each article will be reviewed by two independent reviewers, with a third stepping in to resolve conflicts in decision. After all articles have been screened, data will be extracted in duplicate from the selected included articles using a template in Covidence created by the study team. Results will then be summarized and presented in narrative summary. Discussion An examination of the transplant selection process is due and warranted as selection carries significant weight in determining who receives an organ and, indeed, the stakes are life and death. Yet few studies exist on transplant selection. Ultimately, the problem with selection is how committees can further improve their promise to patients: are they making the right decision and how they define “the right decision.” Thus, it is critical to review selection committees for systematic bias and discrimination, especially in a process that depends heavily on individuals utilizing judgment-based reasoning, in order to improve selection and rid it of historic biases. This way, the transplant candidate selection process can foster fairness, thereby instilling increased public trust.

Cost-effectiveness analysis of MASLD screening using FIB-4 based two-step algorithm in the medical check-up

A study of gene expression programming algorithm for dynamically adjusting the parameters of genetic operators

The fast developments in artificial intelligence together with evolutionary algorithms have not solved all the difficulties that Gene Expression Programming (GEP) encounters when maintaining population diversity and preventing premature convergence. Its restrictions block GEP from successfully handling high-dimensional along with complex optimization problems. This research develops Dynamic Gene Expression Programming (DGEP) as an algorithm to control genetic operators dynamically thus achieving improved global search with increased population diversity. The approach operates with two unique operators which include Adaptive Regeneration Operator (DGEP-R) and Dynamically Adjusted Mutation Operator (DGEP-M) to preserve diversity while maintaining exploration-exploitation balance during evolutionary search. An extensive evaluation of DGEP occurred through symbolic regression problem tests. The study employed traditional benchmark functions and conducted evaluations versus baselines Standard GEP, NMO-SARA, and MS-GEP-A to assess fitness outcomes, R² values, population diversification, and the avoidance of local optima. All key metric evaluations showed that DGEP beat standard GEP along with alternative improved variants. DGEP produced the optimal results for 8 benchmark functions that produced 15.7% better R² scores along with 2.3 × larger population diversity. The escape rate from local optima within DGEP reached 35% higher than what standard GEP could achieve. The DGEP model serves to enhance GEP performance through the effective maintenance of diversity and improved global search functions. The results indicate that adaptive genetic methods strengthen evolutionary procedures for solving complex problems effectively.

An optimized deterministic concurrency control approach for geo-distributed transaction processing on permissioned blockchains

Decoding Variants of Pyrite, Arsenopyrite, and Marcasite Using an Electron Counting Rule

AbstractPyrite (P), marcasite (M), and arsenopyrite (A) are of significant historical and contemporary interest. Compounds adopting these structure types are studied for their crystallographic properties and potential applications in energy storage and conversion. Despite numerous investigations since the 1970s, understanding the chemical behaviour of pyrite, marcasite, and arsenopyrite remains limited. This study proposes a new structure determining electron (SDE) rule to systematise these compounds without relying on formal charge assignments. The SDE rule predicts structure types based on the distribution of non‐localised electrons around transition metals, providing a framework for identifying and categorising related compounds. We observe good agreement with literature data and furthermore synthesised nine new ternary compounds within the Pt/Ir‐Ge–As/Sb systems, demonstrating the applicability of SDE. Our findings reveal that these compounds can be seen as layer configurations of P, M and A, enhancing our understanding of their chemical diversity. This work not only categorises existing compounds, but also paves the way for future exploration of new materials, highlighting the structural potential of P, M, A‐related compounds beyond traditional frameworks. Preliminary results indicate that the type of layers influences physical properties, such as electrical conductivity, warranting further investigation into the relationship between structure and function in these compounds.

The relationship between person-vocation fit and burnout among resident physicians: A single-center cross-sectional survey

Background Burnout among resident physicians affects their physical and mental health as well as the quality of healthcare. Person-Vocation Fit (P-V Fit) may play a key role in preventing burnout. This study aims to explore the relationship between P-V Fit and burnout among resident physicians. Method A cross-sectional survey was conducted, including demographic information, work factors, burnout assessment using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), and the Person-Vocation Fit (P-V Fit) scale. Data were analyzed using logistic and linear regression with SPSS-27. Results 636 resident physicians (response rate 80%) participated in the survey. The mean age was 25.6 ± 2.3 years, 52.5% were male, 90.6% were unmarried, and 55.7% had a bachelor’s degree. The overall burnout rate was 46.07%, with mean scores for emotional exhaustion, depersonalization, and personal accomplishment of 30.5 ± 11.9, 12.9 ± 7.4, and 28.5 ± 9.6, respectively. For each one-point increase in the P-V Fit score, the overall likelihood of burnout decreased by 19% (OR, 0.81;95%CI, 0.76–0.87;P < 0.001), emotional exhaustion decreased by 0.85 points (95%CI, -1.10 to -0.59), depersonalization decreased by 0.55 points (95%CI, -0.73 to -0.38), and personal accomplishment increased by 1.34 points (95%CI, 1.12–1.56)(all P < 0.001). For each additional hour of work, the risk of burnout increased by 33% (OR, 1.33;95%CI, 1.12–1.59;P = 0.001). Conclusion Improving Person-Vocation Fit is an effective strategy for preventing burnout among resident physicians. Residency training should focus on vocational compatibility assessment, develop differentiated support strategies, and arrange reasonable workloads.

Genome-wide analysis provides insight into the genetic diversity and adaptability of Kazakhstan local goats

Abstract To understand the genetic structure of local goat populations in Kazakhstan, we present the first comprehensive genomic analysis using a 70 K SNP array, examining 120 samples from six regions. The populations (Kundyzdy, Darbaza, Shokpar, Ushterek, Kenes and Kosseit) are named based on their breeding regions and are referred to ecotypes. Our results present a high genetic diversity, with observed heterozygosity (Ho) ranging from 0.389 to 0.444. Shokpar and Kundyzdy showed excess heterozygosity, while Kosseit and Darbaza had high inbreeding levels. Most populations recorded weak genetic differentiation, except for Ushterek goats, which were more distinct. For adaptability, Runs of Homozygosity (ROH) and Integrated Haplotype Score (iHS) identified 71 genes under selection, with gene ontology enrichment indicating localization as the most represented biological pathway important for cell response. Additionally, over 60% of these genes are co-expressed, suggesting their significant role in survival of these goats in their local environments. Some identified genes, such as NLRC4, HCLS1, IL17D, IL17RE, and IL17RC, were linked to immune response, an important adaptation trait in the context of climate change. This study not only emphasizes on high genetic variability of local goats in Kazakhstan but also lays the groundwork for developing conservation and breeding programs for local goats in Kazakhstan and other similar agroecological regions for adaptability and resilience under changing environmental conditions.

Ba–Ni–Ge Clathrate Transformation Maximizes Active Site Utilization of Nickel for Enhanced Oxygen Evolution Performance

AbstractDiscovering novel oxygen evolution reaction (OER) (pre)catalysts with exceptional catalytic activity and long‐term stability is pivotal for advancing decarbonization technologies. In this study, we present the ternary Ba8Ni6Ge40 phase with an open clathrate structure exhibiting remarkable performance in alkaline OER. When integrated into an alkaline water electrolyzer, this clathrate precatalyst achieves high stability under a sustained current density of ∼550 mA cm−2 for 10 days. By combining in situ Raman spectroscopy, quasi in situ X‐ray absorption spectroscopy, and (micro)structural characterizations, we elucidate the complete electrochemical transformation of Ba8Ni6Ge40 (~90 weight% leaching) forming ultrathin nanosheets composed of a porous and defective NiOOH nanostructure with maximized accessible active site exposure. Notably, a reversible phase transition mainly between Ni(OH)2 and NiOOH has also been established in the electrochemical redox process. Meanwhile, the successful application of the model Ba8Ni6Ge40 precatalyst represents a promising new class of functional inorganic materials for water electrolysis.

Multi-view clustering via global-view graph learning

Multiview clustering aims to improve clustering performance by exploring multiple representations of data and has become an important research direction. Meanwhile, graph-based methods have been extensively studied and have shown promising performance in multiview clustering tasks. However, most existing graph-based multiview clustering methods rely on assigning appropriate weights to each view based on its importance, with the clustering results depending on these weight assignments. In this paper, we propose an a novel multiview spectral clustering framework with reduced computational complexity that captures complementary information across views by optimizing a global-view graph using adaptive weight learning. Additionally, in our method, once the Global-view Graph is obtained, cluster labels can be directly assigned to each data point without the need for any post-processing, such as the K-means required in standard spectral clustering. Our method not only improves clustering performance but also reduces computational resource consumption. Experimental results on real-world datasets demonstrate the effectiveness of our approach.

Polylepis wood acclimation strategies to ENSO events

A new audio cue to object weight resembles a naturalistic weight cue during movement planning but not during weight illusions

When a person picks up an object, naturalistic cues inform fine motor planning that is reflected in early spikes in force rate changes. Naturalistic cues to weight can also create an illusion whereby a signal to being heavier leads to the object being perceived as lighter – for example, the size-weight illusion. The present study asked to what extent an arbitrary new auditory cue, one that signals object weight, participates in these effects. In Experiment 1, participants used the new signal to adjust both their peak grip force rates and peak load force rates while lifting an object, consistent with using it for efficient motor planning. This matched how they used a naturalistic visual size cue. In Experiment 2, a new audio cue to heavier weight led to a heavier reported weight – the opposite of a size-weight illusion, and opposite to how the same participants used a naturalistic visual size cue. Thus, while the newly learned audio-weight mapping had similar functional properties to its more familiar perceptual counterpart, it did not show the same signature of automatic processing. These results have implications for understanding the flexible use of new cues and for targeting the underlying mechanisms in order to augment human abilities.

The human milk microbiome is minimally associated with breastfeeding practices

Abstract The human milk microbiome is dominated by typical oral and skin bacteria, suggesting that bacterial communities from the infant mouth and maternal skin contribute to the development of the human milk microbiome. It is postulated that breastfeeding characteristics, such as breastfeeding frequency and duration, could lead to different levels of exposure to oral and skin bacteria, and subsequently, altered bacterial profiles in human milk. To investigate the associations between breastfeeding characteristics and the human milk microbiome, this study analysed milk samples collected from 56 participants at 3 months postpartum by full-length 16 S rRNA gene sequencing. Breastfeeding characteristics (breastfeeding frequency, total 24 h breastfeeding duration, and 24 h milk removal volume) were recorded by the participants using the 24 h test weighing protocol. The milk microbiome was largely robust to breastfeeding practices, with only one association detected between breastfeeding characteristics and the milk microbiome. Duration of breastfeeding from the sampled breast (per 24 h) was weakly positively associated with the relative abundance of Streptococcus salivarius (P = 0.035). No associations with alpha nor beta diversity were detected. In conclusion, variations in breastfeeding characteristics do not have a major impact on the composition or diversity of the human milk microbiome.

Effects of a forefoot strengthening protocol on explosive tasks performance and propulsion kinetics in athletes: a single-blind randomized controlled trial

Purpose To investigate the effects of an 8-week “periodized high-load” forefoot strengthening protocol on athlete’s metatarsophalangeal joints (MTPj) flexion torque, MTPj flexors volume, sprint acceleration, cutting, and jumping overall performance and kinetics. Methods Twenty-height highly-trained athletes were randomized into a TRAINING or control group. Following a 4-week control period, TRAINING performed an 8-week forefoot strengthening protocol (2 sessions per week) followed by a 4-week detraining period. CONTROL group athletes were asked to continue their usual activities. During weeks 1, 5, 14 and 18, we assessed MTPj flexion torque, MTPj flexors volume, maximal sprint acceleration, 90-degree cutting, vertical and horizontal jumps, and foot-ankle hops. A linear mixed model was used along with individual statistical analyses using the minimal detectable change (MDC). Results TRAINING significantly and substantially increased MTPj flexion torque and MTPj flexors volume (effect size [ES]: 1.36–1.96; p < 0.001) with 92% of athletes exceeding the MDC. Subsequently, TRAINING induced significant improvements in cutting and horizontal jumping performance (ES: 0.53–1.14; p < 0.01) with 42–67% of athletes exceeding the MDC. These gains were partly attributed to enhanced medio-lateral ground reaction force transmission during cutting and increased propulsive horizontal force production and transmission during jumping (ES: 0.38–0.57; p < 0.05). Despite no effects on overall sprint acceleration performance, vertical propulsion kinetics at maximal speed improved in TRAINING after intervention (ES: 0.87–1.19; p < 0.01). No significant differences were found between the results of the interventional and detraining period demonstrating potential long-lasting effects. Conclusion An 8-week “periodized high-load” forefoot strengthening protocol allowed to improve MTPj maximal torque and MTPj flexors volume. This strength gains led also to cutting, horizontal jump overall performance and kinetics improvement as well as greater maximal speed propulsion kinetics. MTPj strength capacity may exert a more substantial impact on performance and kinetics on horizontally and medio-lateral-oriented explosive movements than on vertically-oriented ones.

Design of PRS enabled monopole slotted-antenna sensor for breast tumor detection

Abstract This article introduces a near-field microwave sensor based on a monopole antenna for breast tumor detection. The designed antenna operates at 2 GHz and is miniaturized by 37% through the etching of two pairs of rectangular slots along its edges, achieving a compact footprint of 0.28λg × 0.42λg (where λg is the guided wavelength at 2 GHz). To enhance gain, a partially reflective surface (PRS) is positioned behind the radiating monopole, increasing the antenna gain from 2.15 to 7 dBi. The monopole antenna is fabricated using Rogers RT5880 (0.787 mm thickness), while the PRS is made from Rogers TMM13i (3.8 mm thickness). The proposed antenna exhibits high radiation efficiency (95–99%) across the 1.9–2.1 GHz bandwidth. A 3D artificial female breast equivalent phantom is developed to evaluate the sensor’s performance. The PRS-enabled antenna is analyzed in terms of reflected and transmitted power variations at different distances from the phantom. Simulation and experimental results confirm that integrating PRS improves the sensor’s sensitivity and its ability to differentiate between healthy and malignant tissues. Furthermore, specific absorption rate (SAR) analysis indicates that an input power of 50 mW meets SAR safety standards. The proposed antenna is compact, simple, and a safer alternative to X-rays, providing a portable solution for effective breast tumor detection.